| NPI | 1528506433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME152448) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 90727) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2023-08-07 |